The Conversation

Changing the Subject on Obesity Prevention

Environmental Obesity DriversCandid conversations about obesity prevention can be difficult. Longstanding prevention strategies are not really working too well. “It’s so hard to change BMI at the population level,” said Marlene Schwartz of Yale’s Rudd Center recently at the National Academy of Sciences. She’s right. We know that many factors all around us are driving more obesity in the roughly 75 percent of people who are biologically susceptible to it. But when asked to name one or two specific primary drivers, all we can really do is speculate. So lately we’ve been seeing an ever greater tendency for changing the subject when awkward questions arise about the effectiveness of obesity prevention.

The simplest approach is to say – quite accurately – that there’s no single cause for the rise in obesity, so it’s unlikely that one single intervention will reverse it. It’s a good way to move on from a sticking point, but it doesn’t eliminate the need to come up with a combination of approaches that will work.

Changing the Subject to Climate Change

With increasing frequency, we’re hearing some folks in public health call for linking up obesity prevention with efforts to prevent climate change. Writing in Current Obesity Reports, Bill Dietz and Sydney Pryor contend that “triple duty solutions” can prevent climate change, undernutrition, and obesity all at once. They contend that a shift toward sustainable food and active transport systems can accomplish this:

“It is our hope that the passions ignited by the climate crisis among young people are approaching those that have fueled other movements. An initial focus on what we can personally change recognizes the urgency of action, driven by an awareness of the consequence of inaction. If we do nothing, it is clear that the effects of climate change on the planet and human health will become irreversible.”

Empiric Evidence for Primary Drivers?

We have little doubt that momentum for preventing climate change is growing. It’s late in coming, but the goal is clear. Cut the emissions of carbon that are heating up the planet. Scientists and politicians are mostly done with fighting over the primary causes of climate change.

Sadly, we have no such clarity on the primary drivers for rising obesity. It’s something about our food systems, but we don’t know precisely what. Ultra-processed foods, sugary drinks, food marketing – we have many suspects. Likewise, many factors in our physical and tech environment are making us less active. Rising levels of stress and distress contribute. So does our exposure to drugs and chemicals that prompt weight gain.

So honestly, it seems that trying to link obesity prevention to efforts for preventing climate change is a stretch. On one hand, the goals for reducing climate change are quite clear – albeit quite hard to meet. We must reduce carbon emissions. On the other hand, the changes that will reduce obesity rates are not so clear.

Changing the subject won’t help. We need to admit that we don’t have this wicked problem figured out. We need better empiric evidence to guide us to obesity prevention strategies that will work.

Click here for more on the rationale for linking obesity, undernutrition, and climate change. For more on doubling down to find obesity prevention strategies that work, click here and here.

The Conversation, painting by Mary Cassatt / WikiArt

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September 11, 2022

2 Responses to “Changing the Subject on Obesity Prevention”

  1. September 11, 2022 at 7:40 am, John DiTraglia said:

    It is true that the cause and maintenance of obesity is complicated like the 6th brake heuristic of Lee Kaplan. But it is certainly not inevitable that the cure won’t be simple and singular for the majority of victims, a la surgery or semaglutide.
    Just saying.

  2. September 16, 2022 at 7:53 pm, John Menchaca, MD said:

    Until we normalize the metabolic status of mothers at the time of conception obesity will continue to be a major problem.